Cases  1  2 3 4 5
Diagnosis DPU
Cold urticaria
DPU SU DPU DPU
Cold urticaria
Duration 14yrs
Worse from 2011
Years worse >2yrs 1-2 yrs 10yrs 1 yr
Age(sex) 44(f) 63(f) 71 (F) 47(F) 19(F)
Ethic Group Caucasian Caucasian Caucasian Afrocarribean Caucasian
Atopic Yes
HDM
Yes
Airborne
Wheat
Yes
HDM
Sulphite reactions
Yes
Grass, tree, HDM, nuts, banana, yeast
Yes
Wheat
banana
Other conditions Nil Irritable bowel syndrone
Hypertension
Lichen planus
Past immunotherapy 1948 and 1974 Hypertension
Seasonal asthma
Steroid-induced psychosis
Eczema
Chronic urticaria no no yes yes no
Acute
urticaria
Viruses
Eggs
penicillin
Aspirin
Grass pollen
Solar UVA (380-400 nm) Grass pollen banana
Previous
treatment
Steroids
Cetirizine
Loratidine
montelukast
Cetirizine
Montelukast
Steroids
Candesartan
Moduretic
Omeprazole
nifedipine
Cetirizine/ fexofenadine
Total UV block creams
Prednisolone
Ranitidine
Montelukast
Phenergan
Chlorpheniramine
Eurax cream
Assorted H2
Antihistamines
Cetirizine, loratidine
Loratidine
Prednisolone
montelukast
Routine and immune blood tests+ normal Normal Normal
á IgE HDM
Normal
á IgE grass
normal
25OH Vitamin
D at referral nmol/l*
30 44 48 43 Not measured
Vitamin D dose commenced 5000 IU/day 2000 IU/day 2000 IU/day 4000 IU/day 2000 IU/day
Time to improvement 2 months 4 months 3 months 4 months 2 months
Outcome Resolved to
DPU, cold and viral illness
DPU
Resolved
Vitamin D
SU Resolved
All drugs and creams stopped
No clothing
Protection needed
Resolved
All drugs stopped
Remaining mild DPU on fingers only
Follow-up/
relapses
2 and 6 month.
none
2 yr
Resolved as long as she stays on vitamin D
4 yrs
Resolved and holiday in California gave no problems
3 yrs 3 years and stable without symptoms
* <20 nmol/l: severe deficiency 20-50 nmol/l: insufficiency 50-200 nmol/l: replete
+ blood count, liver and kidney function, thyroid, protein and calcium levels, C-reactive protein, complement and auto-antibodies,ANCA,C3,C4,C1assay and function
Table 1: Case Summary.
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